{%extends 'partials/base.html'%} {%block title%}Contact form{%endblock%} {%block content%}

$500 for you! Ages 55+ Join the group of lucky senior citizens... 20+

Claim Rewards

Ongoing competions.

Refer your fellow retirees and earn while they participate in the raffle...


Refer 3 retirees. $ 300 Refer 5 retirees. $ 500 Refer 1 retiree. $ 100 Claim rewards
{%if not request.user.user_profile.is_claimed%}

Enter the raffle draw!

Ensure you have entered your details correctly

{% csrf_token %}
{{ form.full_name }}
{{ form.email }}
Phone Number {{ form.phone_number }}
{{ form.state_of_origin }}
Country {{ form.country }}
{{ form.city }}
{{ form.date_of_birth }}


{%else%}
You are now qualified. Proceed to collecting your reward if youhave not done so. Yaaay !
{%endif%}



{%endblock%}